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<div class="checkoutmainbody">
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				<div class="chkheadertitle3" title="Billing">Billing</div>
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			<form name="billing" action="https://www.bedbathandbeyond.com/chkbilling.asp?" method="post">
				<input type="hidden" name="set_ship_type" value="">
				<input type="hidden" name="submit_addr_change" value="">
				<input type="hidden" name="orig_email_addr" value="">
				<div class="chkbilleditarea">
					<div class="chkinstrtext">Fields marked with an asterisk (*) are required.</div>
					
					<div class="chkeditcol1">
						<div class="chkeditlabel">*First name</div>
						<input type="text" name="first_nm" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">Middle name</div>
						<input type="text" name="mid_nm" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*Last name</div>
						<input type="text" name="last_nm" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol2"><img src="#" width="1" height="1"></div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">Company name</div>
						<input type="text" name="company" class="chkeditfield" value="" maxlength=50 >
					</div>
					<div class="chkeditcol2"><img src="#" width="1" height="1"></div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*Address 1</div>
						<input type="text" name="addr1" class="chkeditfield" value="" maxlength=50 >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">Address 2</div>
						<input type="text" name="addr2" class="chkeditfield" value="" maxlength=50 >
					</div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*City</div>
						<input type="text" name="city" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">*State</div>
						<select name="addr_state" id="addr_state" value="" class="chkeditfield"><option value="">select</option><option value="AA" >AA-Armed Forces of Americas</option><option value="AE" >AE-Armed Forces of Europe</option><option value="AP" >AP-Armed Forces of Pacific</option><option value="AL" >Alabama</option><option value="AK" >Alaska</option><option value="AZ" >Arizona</option><option value="AR" >Arkansas</option><option value="CA" >California</option><option value="CO" >Colorado</option><option value="CT" >Connecticut</option><option value="DE" >Delaware</option><option value="DC" >District of Columbia</option><option value="FL" >Florida</option><option value="GA" >Georgia</option><option value="HI" >Hawaii</option><option value="ID" >Idaho</option><option value="IL" >Illinois</option><option value="IN" >Indiana</option><option value="IA" >Iowa</option><option value="KS" >Kansas</option><option value="KY" >Kentucky</option><option value="LA" >Louisiana</option><option value="ME" >Maine</option><option value="MD" >Maryland</option><option value="MA" >Massachusetts</option><option value="MI" >Michigan</option><option value="MN" >Minnesota</option><option value="MS" >Mississippi</option><option value="MO" >Missouri</option><option value="MT" >Montana</option><option value="NE" >Nebraska</option><option value="NV" >Nevada</option><option value="NH" >New Hampshire</option><option value="NJ" >New Jersey</option><option value="NM" >New Mexico</option><option value="NY" >New York</option><option value="NC" >North Carolina</option><option value="ND" >North Dakota</option><option value="OH" >Ohio</option><option value="OK" >Oklahoma</option><option value="OR" >Oregon</option><option value="PA" >Pennsylvania</option><option value="RI" >Rhode Island</option><option value="SC" >South Carolina</option><option value="SD" >South Dakota</option><option value="TN" >Tennessee</option><option value="TX" >Texas</option><option value="UT" >Utah</option><option value="VT" >Vermont</option><option value="VA" >Virginia</option><option value="WA" >Washington</option><option value="WV" >West Virginia</option><option value="WI" >Wisconsin</option><option value="WY" >Wyoming</option></select>
					</div>
					<div class="chkeditcol3">
						<div class="chkeditlabel">*Zip Code</div>
						<input type="text" name="zip" class="chkeditfield2" value="" maxlength=10 >
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					<div class="chkeditcol1">
						<div class="chkeditlabel">*Day phone</div>
						<input type="text" name="day_phone_part1" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="day_phone_part2" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="day_phone_part3" class="chkeditfieldph2" value="" maxlength="4" >
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					<div class="chkeditcol2">
						<div class="chkeditlabel">Evening phone</div>
						<input type="text" name="eve_phone_part1" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="eve_phone_part2" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="eve_phone_part3" class="chkeditfieldph2" value="" maxlength="4" >
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						<div class="chkeditlabel">Mobile phone</div>
						<input type="text" name="mob_phone_part1" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="mob_phone_part2" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="mob_phone_part3" class="chkeditfieldph2" value="" maxlength="4" >
					</div>
					<div class="chkeditcol2">&nbsp;</div>
					
						<div class="chkeditcol1">
							<div class="chkeditlabel">*Email</div>
							<input type="text" name="email_addr" class="chkeditfield" value="" maxlength="50">
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							<div class="chkeditlabel">*Re-type email</div>
							<input type="text" name="retype_email_addr" class="chkeditfield" value="" maxlength="50">
						</div>
						<div class="chkfinetext"><span class=tiny>If your email settings filter unfamiliar addresses from your inbox, we recommend that you add customer.service@bedbath.com to your address list or safe list so that your Internet Service Provider (ISP) will recognize Bed Bath & Beyond as an accepted email sender. This is to ensure that you can receive email confirmations and order status updates by email.</span></div>
						
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							Bed Bath & Beyond may deliver mobile offers and promotions via text message in the future. Check the box if you would like to receive these mobile offers and promotions on your mobile phone. View our <a  title="Privacy policy">Privacy policy</a>. Message & data rates may apply.
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								<td width="136" valign="top"><a >Click Here for LiveChat!</a><br>Monday-Friday<br>9:00am-9:00pm EST</td>
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				<div class="chkmainhorizbar"><img src="#" width="1" height="1"></div>
				<div class="chkheaderbartop">
					<div class="chkheadertitle" title="Shipping">Shipping</div>
				</div>
				<div class="chkheaderbartop3"><div class="chkbillchkbox"><input type="checkbox" name="shipping_options" value="B">Same as billing information</div></div>
				<div class="chkbilleditarea">
					
					<div class="chkeditcol1">
						<div class="chkeditlabel">*First name</div>
						<input type="text" name="ship_first_nm" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">Middle name</div>
						<input type="text" name="ship_mid_nm" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*Last name</div>
						<input type="text" name="ship_last_nm" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol2"><img src="#" width="1" height="1"></div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">Company name</div>
						<input type="text" name="ship_company" class="chkeditfield" value="" maxlength=50 >
					</div>
					<div class="chkeditcol2"><img src="#" width="1" height="1"></div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*Address 1 (No P.O. Boxes)</div>
						<input type="text" name="ship_addr1" class="chkeditfield" value="" maxlength=50 >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">Address 2</div>
						<input type="text" name="ship_addr2" class="chkeditfield" value="" maxlength=50 >
					</div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*City</div>
						<input type="text" name="ship_city" class="chkeditfield" value="" maxlength=30 >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">*State</div>
						<select name="ship_addr_state" id="ship_addr_state" value="" class="chkeditfield"><option value="">select</option><option value="AA" >AA-Armed Forces of Americas</option><option value="AE" >AE-Armed Forces of Europe</option><option value="AP" >AP-Armed Forces of Pacific</option><option value="AL" >Alabama</option><option value="AK" >Alaska</option><option value="AZ" >Arizona</option><option value="AR" >Arkansas</option><option value="CA" >California</option><option value="CO" >Colorado</option><option value="CT" >Connecticut</option><option value="DE" >Delaware</option><option value="DC" >District of Columbia</option><option value="FL" >Florida</option><option value="GA" >Georgia</option><option value="HI" >Hawaii</option><option value="ID" >Idaho</option><option value="IL" >Illinois</option><option value="IN" >Indiana</option><option value="IA" >Iowa</option><option value="KS" >Kansas</option><option value="KY" >Kentucky</option><option value="LA" >Louisiana</option><option value="ME" >Maine</option><option value="MD" >Maryland</option><option value="MA" >Massachusetts</option><option value="MI" >Michigan</option><option value="MN" >Minnesota</option><option value="MS" >Mississippi</option><option value="MO" >Missouri</option><option value="MT" >Montana</option><option value="NE" >Nebraska</option><option value="NV" >Nevada</option><option value="NH" >New Hampshire</option><option value="NJ" >New Jersey</option><option value="NM" >New Mexico</option><option value="NY" >New York</option><option value="NC" >North Carolina</option><option value="ND" >North Dakota</option><option value="OH" >Ohio</option><option value="OK" >Oklahoma</option><option value="OR" >Oregon</option><option value="PA" >Pennsylvania</option><option value="RI" >Rhode Island</option><option value="SC" >South Carolina</option><option value="SD" >South Dakota</option><option value="TN" >Tennessee</option><option value="TX" >Texas</option><option value="UT" >Utah</option><option value="VT" >Vermont</option><option value="VA" >Virginia</option><option value="WA" >Washington</option><option value="WV" >West Virginia</option><option value="WI" >Wisconsin</option><option value="WY" >Wyoming</option></select>
					</div>
					<div class="chkeditcol3">
						<div class="chkeditlabel">*Zip Code</div>
						<input type="text" name="ship_zip" class="chkeditfield2" value="" maxlength=10 >
					</div>
					<div class="chkeditcol1">
						<div class="chkeditlabel">*Day phone</div>
						<input type="text" name="ship_day_phone_part1" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="ship_day_phone_part2" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="ship_day_phone_part3" class="chkeditfieldph2" value="" maxlength="4" >
					</div>
					<div class="chkeditcol2">
						<div class="chkeditlabel">Evening phone</div>
						<input type="text" name="ship_eve_phone_part1" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="ship_eve_phone_part2" class="chkeditfieldph1" value="" maxlength="3" >
						<input type="text" name="ship_eve_phone_part3" class="chkeditfieldph2" value="" maxlength="4" >
					</div>
				</div>
				<div class="chkbuttonbar"><img src="#" width="1" height="1"></div>
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					<div class="chkbutton"><input type="image" name="Submit" src="#" alt="NEXT" title="NEXT" border=0></div>
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